September 16, 2016
Finding root causes
Functional Medicine is a new and fundamentally different approach to medicine. Instead of looking at symptoms and diseases that occur on one part of the body it looks at a larger frame of underlying processes that cause disease in many systems. Often a problem will begin once a certain threshold has been passed and then many different parts of the body are affected. By looking at a timeline of a person’s history it may be possible to narrow the search for causes that lead to a decline in function. By using Functional Medicine we are able to look at the integrity of body-wide systems through a different lens that relates to their function and ability to repair and heal the body, promoting resilience. In doing so, it is possible to identify factors on a biochemical and cellular process level to improve a person’s ability to attain and sustain high levels of function. Successful and sustained resilience and adaptation requires the ability for cells, organ systems and body wide processes to both function at full throttle and to maintain their cohesiveness over time so this level of function can be sustained or improved. Instead of looking at individual organ systems in isolation a Functional Medicine approach takes a whole person vantage. Fundamental activities in the body are categorized into different root cause groupings based on a system parallel to the Institute for Functional Medicine key processes:
- Assimilation – involves how nutrients are digested and absorbed. It also involves analysis and understanding of key bacteria and other organisms that reside within the gut and elsewhere in the body as they have a significant role to play in health and disease both in manufacturing nutrients and in helping to maintain the integrity of the barrier of the gut lining. The respiratory system is another key area of assimilation as oxygen which is the key to metabolism is brought to the body through this route. Many ancient traditions such as TCM [Traditional Chinese Medicine] and Ayurveda among others have long recognized the key role of the breath in sustaining life.
- Defense and Repair – balance in the immune system is important since under-function leads to increased infection and increased risk of cancer. Over-function of the immune system can cause inflammatory problems such as autoimmune diseases. Inflammation is also a subtle factor in the development of heart disease, stroke, and neurologic degenerative diseases such as dementia.
- Energy – key elements of metabolism lead to energy production at the cellular level. This has a significant amount to do with how much vitality an individual has and how well they can sustain their physical and mental performance. An important aspect of this is the health of the mitochondria which are the cell’s energy factories where much of the energy is produced.
- Biotransformation and Elimination – the detoxification of chemicals and the products of metabolism from fats to hormones is regulated at several levels. It occurs in many tissues in the body from the gut to the blood stream, the liver and the kidneys. Various forms of toxicity due to exposures to environmental chemicals also fall under this realm
- Communication – many layers of communication systems exist within the body. Endocrine or hormonal systems involve small molecules that travel through the bloodstream and affect distant organs. Neurotransmitters send signals within the brain and nerves and to muscle and other organs. Immune molecules in tissues and the blood stream alter everything from white blood cell function to mood. Cognition involves central command and control function over the body from the level of the brain.
- Transport – a vast network of blood vessels and lymph channels travel throughout the body to provide nourishment and remove waste products from all the tissues in the body. Their ability to function optimally and the health of the blood vessels themselves are closely related with the state of health of the person as a whole.
- Structural integrity – the degree to which the body is intact and has both strength and flexibility is important at both the level of the musculoskeletal system and at the microscopic level of cellular membranes.
- Other processes not categorized above – includes other holistic and isolated processes not fitting into the principle categories which nonetheless have important effects on health and fitness
While each of these groups of processes seems to be separate they are actually quite interrelated in states of health and disease. Take for instance the situation of a person who has the genes for Celiac Disease but has no symptoms or problems. If the person has the right set of triggering circumstances occur those genes can be activated and a serious reaction to certain proteins in wheat, barley, and rye occurs. This damages the cells that line the gut. Then two things happen – the gut loses its ability to absorb key nutrients [Assimilation problem] and in the damaged state larger molecules that usually stay in the gut leak into the bloodstream. These larger molecules are seen as foreign by the immune system which then attacks them and worse molecules such as those in the joint membranes or in thyroid tissue which have biochemical similarity to those entering the bloodstream are also attacked. This causes autoimmune diseases such as Rheumatoid Arthritis or Autoimmune thyroid problems. [Defense and Repair Problem]. By identifying the root cause – celiac disease, and removing the offending proteins that trigger and sustain the damage the gut can heal and the stimulus that causes the autoimmune disease can be removed. This in turn can lead to improvement or even resolution of the autoimmune disease. Function or dysfunction in many interrelated systems has a large correlation with the ability to function at optimal not just adequate levels. What we consider normal in our society is based on groups of people who at the biochemical, cell structure and system wide function have not maximized the potential of their bodies to function. In our approach each of these sets of processes are examined for factors that are suboptimal. Then through an individualized assessment and optimization process factors that affect both short term function and long term risk and sustainability are identified. Following this it is possible to add a spectrum of options for the person to consider that when implemented may improve both immediate performance and avert future loss of function and difficulties in the months and years ahead.